THE JOURNAL OF THE TOKYO DENTAL COLLEGE SOCIETY

Vol. 108 No. 3      June 2008

ISSN: 0037-3710      UBIC: 342-J

ABSTRACT

Amyloidosis is a disease in which amyloid is deposited in various tissues and organs. We report a case where radiotherapy was given after diagnosis of tongue amyloidosis was pronounced following a diagnosis of tongue cancer at another clinic. The patient was a 67-year-old man who visited our department with the chief complaint of tongue pain. The patient who was undergoing hemodialysis for renal failure, had been receiving interstitial radiation at the department of radiology at a university hospital for a tumor that had developed 6 months previously which that had been diagnosed as tongue cancer. However, no tumor reduction was observed. One month after initiation of radiotherapy, the patient was informed by his doctor that the diagnosis of tongue cancer had been incorrect, and treatment was discontinued. The patient visited our hospital after recently developing tongue pain. At the initial visit, white tumors with induration were observed on both sides of the tongue, with bleeding in some areas. T2-weighted MRI revealed lesions showing high signal intensity on the margins of both sides of the tongue, as well as the proglossis. As tongue amyloidosis was suspected based on the patient's history, test findings, and history of dialysis, and pathological tests were performed. Tongue cytology revelled Papanicolaou class II, while histology confirmed the diagnosis of tongue amyloidosis. Although systemic examination was performed by an internist, no clear findings indicative of amyloidosis were observed in any other organ. Systemic amyloidosis often presents in the oral cavity as primary amyloidosis, or as a partial symptom of multiple myeloma. In addition, its incidence dialysis patients, such as the present patient, is believed to be high, due to accumulation of β2 microglobulin, a primary component of amyloid deposits. As tongue amyloidosis often presents with induration, and may thus be erroneously diagnosed as tongue cancer, it requires sufficient examination, including pathological diagnosis. (The Shikwa Gakuho, 108 : 241-246. 2008) Key words: Amyloidosis, Hemodialysis, Tongue cancer.

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